Ces radiol. 2021, 75(2):177-183 | DOI: 10.55095/CesRadiol2021/022

Evaluation of results of endovascular treatment for acute ischemic stroke according to the recommendations of international multi-society consensus: What is necessary to follow and can be the stated criteria fulfilled?Original article

Martin Kocher¹, Daniel Šaňák², Jana Zapletalová³, Marie Černá¹, Tomáš Veverka², Vojtěch Prášil¹, Michal Král², Tomáš Dorňák², David Franc², Petr Polidar²

¹ Komplexní cerebrovaskulární centrum, Radiologická klinika LF UP a FN, Olomouc

² Komplexní cerebrovaskulární centrum, Neurologická klinika LF UP a FN, Olomouc

³ Ústav lékařské biofyziky LF UP, Olomouc

Aim: Mechanical thrombectomy (MT) of symptomatic occlusion of cerebral artery has become a standard treatment in acute ischemic stroke (IS) patients. Based on analysis of previously published results, the recommendations for the centers performing MT were introduced in the year 2018 and became accepted as indicators of quality of care. The aim of presented study was to evaluate if our center was able to follow the recommendations established by international multi-society consensus, and furthermore, to assess a trend of recommended indicators during the time using a comparison of our results between years 2016 and 2019.

Methods: All consecutive acute IS patients with large vessel occlusion both in anterior and posterior circulation treated in our center in the year 2019 were included in the analysis. All demographic and clinical data, as well as time parameters and treatment results were collected prospectively. Data were subsequently compared with recommended values of individual parameters of multi-society consensus. The results of the year 2019 were subsequently compared with those from the year 2016 to assess a trend in our center.

Results: In total, 152 patients (52% of males, mean age: 71.2 ± 13.2 years) were indicated to MR in our center in the year 2019. In 75% of patients indicated to MT, brain imaging was started within 23 min after patient's arrival to center, groin puncture was performed within 62 min after patient's arrival to center (primary transport), and in 70% of patients, recanalization was achieved within 34 min after groin puncture. Recanalization (mTICI ≥ 2b) was achieved in 133 (87.5%) patients a completed (mTICI 3) in 102 67.2%) patients. Eighty (52.6%) patients reached good 3-month clinical outcome (mRS 0-2). Symptomatic intracerebral hemorrhage after MT occurred in 5 (3.4%) patients.

Conclusion: Our results showed that it was possible fulfill the recommended values of parameters stated in the international multi-society consensus also in Czech Republic and thus, the can be recommended as indicators of quality of care.

Keywords: acute ischemic stroke, mechanical thrombectomy, indicators of quality of care, stent-retriever, aspiration

Grants and funding:

Práce byla podpořena grantem RVO FNOL_00098892_2020.
Supported by grant RVO FNOL_00098892_2020.

Accepted: May 30, 2021; Published: June 1, 2021  Show citation